Tell us about your child

We'll use this to match your family with the right therapist and approach.

Child's first name

Child's last name

Child's date of birth

Primary concern

About you

How can we reach you? We'll never share your information.

Your first name

Your last name

Phone number

Email address

A few more details

Almost there. This helps us prepare for your consultation.

Insurance provider

How did you hear about us?

Anything else you'd like us to know? (optional)

I consent to being contacted by Jars of Play Speech Therapy by phone or email regarding this inquiry. I understand my information will be kept confidential and used only to respond to my request. Submitting this form does not establish a therapist–patient relationship. Privacy Policy.

I'd like to receive helpful speech and language tips, clinic news, and resources from Jars of Play by email. I can unsubscribe at any time. (optional)

You're all set!

We'll be in touch within one business day to confirm your intro call or email.

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Play-based speech therapy session at Jars of Play, Prosper TX

"She meets us with kindness every time and celebrates every victory, big or small."
Baleigh H., Jars of Play family